Financial Coordinator - Pharmacy

Lehigh Valley Health Network, Inc.; Allentown, Northern (Lehigh County, KY); Hybrid; USD 42,000 - 62,000; Full time

Job summary

Lehigh Valley Health Network seeks a Financial Specialist for Home Infusion Pharmacy and related services. You will communicate medical conditions and treatment plans to carriers and suppliers to determine coverage, obtain authorizations when needed, and monitor accounts receivable in coordination with Pharmacy.

The role requires knowledge of pharmacy operations, insurance terminology, and coding. Strong communication with patients and providers is essential for success.

Qualifications

• 3 years Insurance verification or medical billing.
• 3 years in a Pharmacy related field.
• Knowledge of ICD-10, CPT, and HCPCS coding.
• Knowledge of insurance carriers, Medicare, Medicaid, and managed care regulations.
• Computer proficiency.
• Knowledge of pharmacy operations including order preparation, patient monitoring and home delivery.

Responsibilities

• Acts as the financial representative to all potential pharmacy patients.
• Maintains a perpetual knowledge of pharmacy Payer standards and requirements for pharmacy patient billing.
• Educates patients on coverage, prescription coverage, and any assistance programs that they may be eligible.
• Obtains pre-certification and/or prior authorization if required by insurance companies and ensures that they are always up-to-date and active.
• Verifies accuracy of billing and payment information received and assists in obtaining more information.
• Verifies patient insurance coverage including prescription coverage.
• Maintains up-to-date documentation regarding insurance information and coverage.
• Serves as a billing and insurance resource for colleagues, physicians, and patients.

Skills

Insurance verification

Medical billing

Pharmacy operations

Medical terminology

ICD-10 coding

CPT CPT? HCPCS

Computer proficiency

Medicare/Medicaid knowledge

Education

High School Diploma or GED

Bachelor's degree

CPhT — Certified Pharmacy Technician

Job description

**Join a team that delivers excellence.**Lehigh Valley Health Network (LVHN) is home to nearly 23,000 colleagues who make up our talented, vibrant and diverse workforce.Join our team and experience firsthand what it's like to be part of a healthcare organization that's nationally recognized, forward-thinking and offers plenty of opportunity to do great work.Imagine a career at one of the nation's most advanced health networks.Be part of an exceptional healthcare experience. Join the inspired, passionate team at Lehigh Valley Health Network, a nationally recognized, forward-thinking organization offering plenty of opportunity to do great work.LVHN has been ranked among the \"Best Hospitals\" by U.S. News & World Report for 23 consecutive years. We're a Magnet(tm) Hospital, having been honored five times with the American Nurses Credentialing Center's prestigious distinction for nursing excellence and quality patient outcomes in our Lehigh Valley region. Finally, Lehigh Valley Hospital - Cedar Crest, Lehigh Valley Hospital - Muhlenberg, Lehigh Valley Hospital- Hazleton, and Lehigh Valley Hospital - Pocono each received an 'A' grade on the Hospital Safety Grade from The Leapfrog Group in 2020, the highest grade in patient safety. These recognitions highlight LVHN's commitment to teamwork, compassion, and technology with an unrelenting focus on delivering the best healthcare possible every day.Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network. **Summary** Monitors and obtains financial information and authorizations to ensure appropriate coverage for patients related to Home Infusion Pharmacy, Nursing and Specialties. Communicates medical conditions and treatment plans to carriers and suppliers to determine coverage. Obtains authorizations for services if needed. Provides counseling to patients and their families regarding covered services and financial responsibility. Monitors, applies payments and adjustments on Accounts Receivable. Works closely with Pharmacy to coordinate outpatient infusion services. Knowledge of pharmacy operations is required. **Job Duties*** Acts as the financial representative to all potential pharmacy patients.* Maintains a perpetual knowledge of pharmacy Payer standards and requirements for pharmacy patient billing* Educates patients on coverage, prescription coverage, and any assistance programs that they may be eligible.* Obtains pre-certification and/or prior authorization if required by insurance companies and ensures that they are always up-to-date and active.* Verifies accuracy of billing and payment information received and assists in obtaining more information.* Verifies patient insurance coverage including prescription coverage.* Maintains up-to-date documentation regarding insurance information and coverage.* Serves as a billing and insurance resource for colleagues, physicians, and patients. **Minimum Qualifications*** High School Diploma/GED* 3 years Insurance verification or medical billing. or* 3 years in a Pharmacy related field* Knowledge of medical terminology and all aspects of coding including ICD-10, CPT, and HCPCS.* Computer proficiency.* Knowledge of insurance carriers, Medicare, Medicaid, and managed care regulations.* Knowledge of third-party insurance medical benefits and billing requirements.* Knowledge of pharmacy operations including order preparation, patient monitoring and home delivery. **Preferred Qualifications*** Bachelor’s Degree* CPhT - Certified Pharmacy Technician - State of Pennsylvania Upon Hire **Physical Demands** Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, \\*patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR. Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.